Provider Demographics
NPI:1174062996
Name:DENISE PURVIS BILLING SERVICES
Entity type:Organization
Organization Name:DENISE PURVIS BILLING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:PURVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-226-8146
Mailing Address - Street 1:106 JATA DR
Mailing Address - Street 2:
Mailing Address - City:MONROE CENTER
Mailing Address - State:IL
Mailing Address - Zip Code:61052-9794
Mailing Address - Country:US
Mailing Address - Phone:815-226-8146
Mailing Address - Fax:
Practice Address - Street 1:5301 E STATE ST STE 301
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-2399
Practice Address - Country:US
Practice Address - Phone:815-226-8146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health